On Oct. 13, JAMA Network Open published an Original Investigation entitled, “COVID-19 Vaccine Acceptance and Access Among Black and Latinx Communities.”
The authors state that “More than 99 percent of deaths from COVID-19 are now among unvaccinated individuals. Black and Latinx communities experience two-fold the rate of death due to COVID-19 compared with their white counterparts, and factors rooted in structural racism continue to impede equal access to health for all. Striking racial and ethnic disparities also exist in COVID-19 vaccination rates and vaccine access. As of July 2021 in the U.S., among individuals who have received one dose of the vaccine, 58.9 percent were White, 16.1 percent Hispanic, and 9.3 percent were Black, which lags behind national racial and ethnic representation.”
The authors write that data continues to show lower vaccination coverage in Black and Latinx communities and COVID-19 cases continue to increase, making it important to understand the barriers to vaccine acceptance and access.
The authors explain that “A total of 79 participants agreed to take part in the study, of whom seven did not attend and were categorized as nonparticipants. Our final study sample was 72 participants, with 36 (50 percent) identifying as Black, 28 (39 percent) as Latinx, and eight (11 percent) as Black and Latinx; 56 participants (78 percent) identified as women and 16 (22 percent) identified as men. Participants were largely from three age categories: 50 to 64 years (34 participants [47 percent]), 30 to 49 years (24 participants [33 percent]), and 18 to 29 years (13 participants [18 percent]). Employment backgrounds reflected the diversity of the New Haven community, including teachers, custodial service workers, and health care workers.”
The themes identified centered around trust and addressing barriers to vaccine access and categorized into three key themes:
- Pervasive mistreatment of Black and Latinx communities and associated distrust
- Informing trust via trusted messengers and messages, choice, social support, and diversity
- Addressing structural barriers to vaccination access
The authors write that “Participants shared experiences of unequal death from the medical system that contributed to fears of interacting with the health care system and getting vaccinated. One participant shared, ‘People die from childbirth, regular colds…they’re just ignored…so, I feel that’s a huge part of moving with getting this vaccine.’ Another participant expressed that vaccine concerns were related to the disparate death rates from COVID-19 in African American communities. ‘Knowing a lot of disparities that are with African Americans in health and seeing just the different reactions that people have with COVID[-19]…I feel like there’s just as much risk in allowing yourself to kind of get COVID[-19] as much as getting a vaccine.’”
“Participants frequently cited pervasive and ongoing mistreatment of Black and Latinx communities by the health care system as factors influencing vaccine acceptance,” the authors write. “Mistreatments included perceptions of having their opinion “thrown away” and having their voice go unheard by the health care system. These experiences were then related to COVID-19 vaccinations. One participant explained, ‘I had to fight my way to get certain things done for my health. They don’t take you seriously sometimes…that kind of contributes to the fear of wanting to get vaccines.’”
The authors conclude that structural barriers emphasize the narrative of inequitable access to COVID-19 vaccinations and larger healthcare systems need to make changes to ensure equity. Vaccine distribution patterns should be analyzed and reassessed to ensure distribution is satisfactory and consistent to communities with high social risk indices and those that are affected more by the pandemic. The authors suggest that to remove barriers mobile clinics, same-day clinics, and walk-in vaccination sites can be used, as well as highlighting the no-cost nature of the vaccine and removing requirements for documentation. “We stand at a time when overcoming vaccination barriers will not only determine whether disparities in outcomes for Black and Latinx communities are worsened but also determine whether vaccination efforts are able to sufficiently mitigate the progression of the pandemic through variants in the coming year,” the authors write.
